Aim: Retrospective blinded flash glucose monitoring system (FGMS) is typically used for 14 days, prior to modification of therapy. We sought to assess the efficacy of a novel approach wherein an interim analysis was done within a week of starting FGMS and utilized to implement therapeutic modifications. The same sensor was reassessed within the following week to see the changes in glycemic control, thereby maximizing utility of a single sensor.

Methods: This is a retrospective analysis of 1consecutive adults with T2DM and HbA1c >7% on pharmacotherapy (oral agents and/or insulin) at a single centre. Patients started on blinded FGMS (Freestyle Libre Pro) were assessed within 1 week to get baseline estimate of glycemic trends. Glucose target range was set at 70-180 mg/dL. Patients kept a food log while on FGMS. Based on the glucose profile reports, dietary and pharmacotherapy changes were made and patients were re-evaluated in the next 7 days to assess the changes due to IIT, while wearing the same sensor. Analysis of pre and post: daily average glucose (DAG), time in target range (TITR), time above target range (TATR) and time below target range (TBTR) was performed.

Results: At baseline, patients had a DAG of 191.3 mg/dL. Average time for interim analysis was 5 days after FGMS initiation. After IIT, the DAG dropped to 137.4 mg/dL, within 14 days (p <0.001). The TATR dropped from 52.1% to 18.3% (p<0.001), with a concurrent decrease in TBTR from 5.7% to 1.5% (p<0.001). Recurrent hypoglycemias were detected in 27 (25%) patients, with average TBTR being 21.1% and TITR being 65.7% on interim analysis. Following IIT, the TBTR reduced to 1.9% (p<0.001) and TITR changed to 86.8% (p<0.001), without increase in TATR in these patients.

Conclusion: Using IIT, changes to patient’s lifestyle and/or pharmacotherapy can be made within a few days of FGMS, with the ability to gauge subsequent changes while still utilizing the same sensor. Significant improvement in glycemic control was achieved using this technique.

Disclosure

A.B. Jain: Speaker's Bureau; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Sanofi.

© 2018 by the American Diabetes Association.
2018
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